The Legislature is back in session, and that means it’s head-spinning time in Augusta.

The main event is the debate over accepting 100 percent federal Medicaid funding to cover 70,000 Maine people for the next three years, and an average of 93 percent funding over the next 10 years. Gov. Paul LePage and Republicans legislators who’ve tied their fate to his continue to come up with one unpersuasive reason after another to avoid the obvious conclusion: That hundreds of millions of federal dollars would be a boon to Maine’s economy, not to mention its effect on improving the lives and health of its citizens.

As Steve Michaud of the Maine Hospital Association points out, Maine enthusiastically accepts federal money for highways and bridges, sewage treatment and water systems, and a host of other programs at rates requiring state matches far greater than what’s being asked for MaineCare.

He writes, “If this were an opportunity for federal dollars for a ship at Bath Iron Works or a defense contract or for highways and bridges, we would be jumping at the opportunity and celebrating.” Hospitals, he adds, “see no reason to forgo this level of funding just because it’s health care.”

LePage is unmoved, but in other areas he seems to be rethinking his opposition to just about any kind of government spending. He partnered with DOT Commissioner David Bernhardt at a news conference to unveil a $2 billion, three-year transportation plan that he said will be kick-started by the $100 million bond issue voters approved in November.

“Our transportation infrastructure is the backbone that delivers economic opportunities and good-paying jobs to Maine,” LePage said — sounding very much like a governor whose re-election bid will be decided in November.

It wasn’t always like this. LePage didn’t mention, and reporters were apparently too polite to ask about, his decision to impound a 2010 transportation bond for $47.5 million pending when he took office in 2011 — or the $50 million transportation bond approved in 2012 that LePage said he didn’t support and wouldn’t vote for. That was just before he unveiled the $100 million bond for 2013 that he really, really likes — even though the first two bonds are just as integral to his suddenly big election-year plan for transportation.

About that plan — reading the fine print, only the first year, $455 million, is paid for. The remaining three-quarters over the next two years is, well, speculative at best. LePage ended gas tax indexing that kept the value of the highway fund from eroding and opposes any tax increase. There’s no new money from Washington, either.

LePage’s refusal to put public money to work until the last year of his term is, in part, what caused the construction industry’s unemployment rate to soar to 26 percent. The state economy could have really used those dollars three years ago, but the governor said no.

LePage, or his advisors, may have finally realized that his blockading of the normal channels of state spending, even those explicitly endorsed by the voters, was boomeranging. Maine’s economic performance, rarely robust, has been alarmingly flat throughout the aftermath of the Great Recession.

And if the advisers look at the Medicaid situation, they will find that refusal there is an even worse idea. First, there’s a lot more money at stake; health care spending dwarfs just about everything else in the state and national economy.

And, as Steve Michaud also points out, hospitals are already facing a $900 million cut over 10 years in Medicare reimbursements they receive to treat seniors. The expanded Medicaid funding is what’s supposed to replace those dollars. Without it, hospital layoffs and cutbacks may dwarf what we’ve already seen over the past two years.

The Medicare reductions make sense —we have to do something about outrageously high health care costs, and reimbursement cuts may be a blunt technique, but they’re about all we have under our current hybrid, ill-organized health care system. But not taking the Medicaid dollars to cover the currently uninsured is just asking for trouble, as a number of Republicans governors around the country have finally begun to realize.

It may be too late for Paul LePage to change course. He’s convinced himself that health care for low-income Mainers is “welfare,” and “welfare,” to the governor, is always a bad thing.

But it’s not too late for the legislators who have been listening a little too much to LePage, and not enough to their constituents. They, too, are on the ballot, and being against health care and federal dollars coming to Maine isn’t a great re-election stance.

Douglas Rooks is a former daily and weekly newspaper editor who has covered the State House for 29 years. He can be reached at [email protected]

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